Ortho Question regarding Medicaid?

[CountinCavities]

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I have been researching this a bit and I just want more insight.

Are there ever cases where a child/young adult on medicaid would be covered for orthodontic treatment?

I apologize if this question is ridiculous, I hesitated to put it up...but I thought you all could teach me something.

 

[Lily143]

In Texas, yes.

 

[Istr8nthem]

I have been researching this a bit and I just want more insight.

Are there ever cases where a child/young adult on medicaid would be covered for orthodontic treatment?

I apologize if this question is ridiculous, I hesitated to put it up...but I thought you all could teach me something.

New York City has a medicaid orthodontic rehabilitation program. As a patient, you need to go through two screening appointments and get accepted (supposed to have a debilitating malocclusion) to be completely covered by medicaid. The system is broken, so many patients that don't really meet the minimum requirements are still getting accepted. There is some partial treatment funding as well for interceptive (phase I) and for limited treatment cases (normally something like CL I buccal segments with a tooth or two in anterior crossbite, or mild-moderate spacing cases).

New York State (as a whole) has a similar program, but it is much more strict with it's funding for cases (must be a severe malocclusion).

I know other states have programs similar but not sure which ones they are.

 

[CountinCavities]

New York City has a medicaid orthodontic rehabilitation program. As a patient, you need to go through two screening appointments and get accepted (supposed to have a debilitating malocclusion) to be completely covered by medicaid. The system is broken, so many patients that don't really meet the minimum requirements are still getting accepted. There is some partial treatment funding as well for interceptive (phase I) and for limited treatment cases (normally something like CL I buccal segments with a tooth or two in anterior crossbite, or mild-moderate spacing cases).

New York State (as a whole) has a similar program, but it is much more strict with it's funding for cases (must be a severe malocclusion).

I know other states have programs similar but not sure which ones they are.

Thank you for all of that information. So would you say that it is very important for states to have these programs? I am in Florida and wondering whether or not there are programs to help the poor afford orthodontic work here. I volunteer at a public health clinic and the care is limited. I'm in an undergrad class right now where we are supposed to pick a topic and propose a policy for change and become more involved in the topic by volunteering. Since, I have not seen a public health clinic that has does ortho, I was wondering if they exist in Florida.

 

[mike3kgt]

Thank you for all of that information. So would you say that it is very important for states to have these programs? I am in Florida and wondering whether or not there are programs to help the poor afford orthodontic work here. I volunteer at a public health clinic and the care is limited. I'm in an undergrad class right now where we are supposed to pick a topic and propose a policy for change and become more involved in the topic by volunteering. Since, I have not seen a public health clinic that has does ortho, I was wondering if they exist in Florida.

http://www.hrsa.gov/reimbursement/states/Florida-Medicaid-Covered-Services.htm

"Reimbursable dental services for children under age 21:

· Diagnostic examinations;

· Radiographs necessary to make a diagnosis;

...so on...

· Orthodontic treatment."

"Orthodontics for children are limited to treatment of severely handicapping malocclusions or corrections of a dental condition deterring physical development. Prior authorization is required for all orthodontic services except the initial evaluation."

-------

I am a dentist from Florida, practiced for 2 years and part time at a community health center during some of that time. There are options for orthodontics for children with handicaps and severe problems. It is a covered Medicaid benefit at this time, the two dental schools provide cheaper options for ortho, and there are some public grant-funded programs that can help.

I am in full favor if not-for-profits wanted to develop a system of grants or donations for those truly needy for orthodontic services. You will find when you do your research, however, there will ALWAYS be more people who need services and some is never enough. To help the truly physically handicapped with a state-supported service is fantastic... expanding it beyond that group leads to abuse.

I moved out of state and practice in an office that took Medicaid... We did not accept Medicaid at our clinic, my practices, or anywhere I worked in Florida. I could not even count how many people came into the office (outside of FL) asking me to sign their orthodontic consults and telling me which boxes to check... even though their children were perfectly normal, just they wanted the state to pay for their ortho. The same complaint, "my son has these spaces that I just don't like, I want him to get braces!!" I refused every time, but I know they were just going down the street to the next guy who would sign it... ah well.

Florida has the best, fairest dental coverage for medicaid at this time... full coverage for most services for children, and emergency-only services for adults (extractions, I&Ds). Maybe this type of thinking shows why my taxes are low, dentistry is great (in FL), and the amount of dental plan hassle is low.

Why don't you write about the benefits of community health centers (Rural Health Networks, CHCs, etc) for providing needed services for dentistry at the public health level?

 

[CountinCavities]

http://www.hrsa.gov/reimbursement/states/Florida-Medicaid-Covered-Services.htm

"Reimbursable dental services for children under age 21:

· Diagnostic examinations;

· Radiographs necessary to make a diagnosis;

...so on...

· Orthodontic treatment."

"Orthodontics for children are limited to treatment of severely handicapping malocclusions or corrections of a dental condition deterring physical development. Prior authorization is required for all orthodontic services except the initial evaluation."

-------

I am a dentist from Florida, practiced for 2 years and part time at a community health center during some of that time. There are options for orthodontics for children with handicaps and severe problems. It is a covered Medicaid benefit at this time, the two dental schools provide cheaper options for ortho, and there are some public grant-funded programs that can help.

I am in full favor if not-for-profits wanted to develop a system of grants or donations for those truly needy for orthodontic services. You will find when you do your research, however, there will ALWAYS be more people who need services and some is never enough. To help the truly physically handicapped with a state-supported service is fantastic... expanding it beyond that group leads to abuse.

I moved out of state and practice in an office that took Medicaid... We did not accept Medicaid at our clinic, my practices, or anywhere I worked in Florida. I could not even count how many people came into the office (outside of FL) asking me to sign their orthodontic consults and telling me which boxes to check... even though their children were perfectly normal, just they wanted the state to pay for their ortho. The same complaint, "my son has these spaces that I just don't like, I want him to get braces!!" I refused every time, but I know they were just going down the street to the next guy who would sign it... ah well.

Florida has the best, fairest dental coverage for medicaid at this time... full coverage for most services for children, and emergency-only services for adults (extractions, I&Ds). Maybe this type of thinking shows why my taxes are low, dentistry is great (in FL), and the amount of dental plan hassle is low.

Why don't you write about the benefits of community health centers (Rural Health Networks, CHCs, etc) for providing needed services for dentistry at the public health level?

Wow, thank you so much for all of that information. I can see what you are saying and I am really glad to hear how the system works. I think looking into CHCs is a great idea to discover what other ways dentists can help. I googled a CHC near my house and I am going to get in touch with them. Thank you again.